目的 了解三级甲等医院急诊科护士组织沉默与结构授权的现状，探讨两者之间的相关性。 方法 2023年1月-2月， 采用便利抽样法选取上海市5所三级甲等医院急诊科的护士为研究对象，采用员工沉默行为调查问卷与工作效能条件量表进行调查，并进行相关性分析。 结果 138名急诊科护士组织沉默总分为（36.75±12.56）分，3个维度中默许沉默条目均为（3.33±1.23）分、漠视沉默为（3.06±1.19）分、防御沉默为（2.80±1.20）分，结构授权总分 为（61.03±13.73）分，组织沉默与结构授权呈负相关（P<0.01）。 结论 三级甲等医院急诊科护士存在中等程度的组织沉默，组织沉默与结构授权呈负相关，结构授权水平越低，则其组织沉默程度越重。 提示管理者可通过增强结构授权减少甚至消除急诊科护士组织沉默。

Objective To understand the current situation of organizational silence and structural authorization a- mong emergency department nurses in tertiary Grade A hospitals，and to explore the correlation between the two factors. Methods The nurses from the emergency departments of 5 tertiary hospitals in Shanghai were selected as the research subjects by convenient sampling from January to February of 2023. A survey was conducted using the Employee Silence Questionnaire and the Work Efficiency Condition Scale，and a correlation analysis was conducted. Results The results showed that 138 nurses in the emergency department had a score of （36.72±12.56） for or- ganizational silence. Among the three dimensions，the score of tacit silence was （3.33±1.23），indifference silence was （3.06±1.19），defense silence was （2.80±1.20），and structural authorization was （61.03±13.73）. There was a negative correlation between organizational silence and structural authorization （P<0.01）. Conclusion Nurses in the emergency department of tertiary Grade A hospitals have moderate level of organizational silence，which is negative- ly correlated with structural authorization. The lower the level of structural authorization，the heavier the degree of organizational silence. This suggests that managers can reduce or even eliminate organizational silence among emer- gency department nurses by enhancing structural authorization.